Treatment Of Gallstone Ileus Research Articles

30-year experience of the diagnosis and treatment of gallstone ileus

30-year experience of the diagnosis and treatment of gallstone ileus

Treatment of gallstone ileus by balloon enteroscopy–guided laser lithotripsy (with video)

Treatment of gallstone ileus by balloon enteroscopy–guided laser lithotripsy (with video)

Difficult Management of Giant Gallstone Ileus of a Post-cardiopulmonary Resuscitation Patient: A Case Report

Gallstone ileus is a rare form of mechanical intestinal obstruction. It is associated with high mortality and morbidity in the elderly population. The treatment of gallstone ileus includes more than one surgical option and it is appropriate to determine the surgical technique according to the general condition of the patient.In our case report, we present an 83-year-old patient who was admitted to the emergency room due to nausea and vomiting, was diagnosed with gallstone ileus, and had a cardiac arrest just before surgery. The patient management and the following surgical approach are also explained in detail.

Diagnosis and treatment of Gallstone ileus with Cholangitis and Cholecystoenteric fistula in an Elderly Female

A 88yr old female known case of diabetes, hypertension and CKD presented with fever and Chills for 15 days with yellowish discolouration of sclera and urine for 5 days. On evaluation she was found to have evidence of Calculus Cholecystitis, Choledocholithiasis and Cholangitis. Patient was managed with IV fluid, IV antibiotics and other supportive treatment. ERCP was planned. After CBD Cannulation with Sphincterotomy and ballon sweeping, Pus, fragmented stones and black bile came out. After multiple ballon sweeping and clearing CBD plastic stent was placed.Patient was discharged as she was asymptomatic after 7 days. Removal of GB was deferred as patient's family denied the same. However after 15days she presented with recurrent vomiting and abdominal distension. CT abdomen revealed large Cholecysto-enteric fistula and Calculus within mid small bowel suggestive of gall stone ileus. Exploratory laparotomy with enterostomy was done. Investigations-Sonography, CT abdomen, LFT Diagnosis-Cholangitis, Cholecysto-enteric Fistula and Gall stone ileus Management-ERCP, Stenting,Surgery (Exploratory laparotomy with enterostomy) Key words-Cholecysto-enteric fistula, Gall stone ileus, Cholangitis

Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus.

Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures.

Enterolithotomy and early cholecystectomy, an application of damage control surgery for patients with gallstone ileus

Abstract Background Recurrent gallstone ileus is an uncommon mechanical intestinal obstruction secondary to occlusion of the intestine by an intraluminal biliary calculus. Clinical case A 75-year-old female, ischaemic heart disease (stent), arrived in our department complaining of abdominal pain and vomiting. Computed tomography showed gallstone ileus. The patient underwent an enterotomy with gallstone removal. Three months later, the patient came back with the same clinical symptoms and signs. A new computed tomography highlighted a gallstone ileus again. Enterolithotomy and gallstone removal, cholecystectomy and closure of cholecystoduodenal fistula were performed. The patient had a prolonged hospital stay due to the development of congestive heart failure. Case 2. A 71-year-old male, ischaemic heart disease and aortocoronary bypass, seen in our department complaining of vomiting. Computed tomography showed aerobilia and gallstone ileus. The patient underwent an urgent enterolithotomy. Seven months later, the patient came back with the same clinical symptoms and signs. Computed tomography showed a new gallstone ileus. An enterotomy and gallstone removal, cholecystectomy and closure of cholecystoduodenal fistula were performed. The patient died due to multi-organ failure in post-surgery period. Conclusion In the elderly patients with concomitant medical illnesses with the risk of a second laparotomy, it is justifiable to reconsider the definitive repair in the treatment of gallstone ileus. The enterolithotomy in acute phase followed by early cholecystectomy (4–8 weeks) may be a safe method for eliminating, not only the possibility of recurrent gallstone ileus, and probably the need for a second laparotomy, but also the exceptional possibility of developing a gallbladder carcinoma.

Diagnosis and treatment of gallstone ileus

Gallstone ileus is a rare mechanical ileus,which was caused by discharge of giant gall bladder stone to the intestine.Understanding the causes of ileus is the key factor for treatment,and surgical treatment is the treatment of choice.An old patient with gallstone ileus was admitted to the Second Affiliated Hospital of Soochow University in April 2013.Preoperative X ray detection and computed tomography showed gallbladder wall thickening,formation of a sinus tract between the gall bladder and the duodenum,and intestinal ileus in the left iliac region (the diameter of the stone was about 4 cm).The patient received medical treatment for 3 days and then exploratory laparotomy + lithotomy.Gall bladder stones were not detected during the operation,so the gall bladder was preserved.The patient was followed up till December 2013,the sinus tract was disappeared under B sonography,and the cholecystitis was cured. Key words: Gallstone ileus; Internal biliary fistula; Cholelithiasis

Abdome agudo por obstrução por ileobiliar

To perform a systematic review of the history, available image exams and clinical approach to the diagnosis and treatment of gallstone ileus. Retrospective study in a university hospital including all cases of SBO treated over a period of 23 years. According to the surgical treatment the patients were divided into two groups: (1) enterolithotomy with cholecystectomy performed later (two-stage surgery); and (2) enterolithotomy, cholecystectomy and fistula closure (one-stage surgery). Twelve patients were included in the study, including 11 females (91,6%), with a mean age of 72.2 years. All patients presented associated diseases, mainly arterial hypertension (75%). All except one patient had multiple SBO symptoms. Gallstone ileus diagnosis was achieved in six patients (50%) before laparotomy. There were 8 patients in group 1 and 4 in group 2, and the morbidity was, respectively, 33.3% and 8.3%. Overall mortality was 16.6% (one patient in each group). Gallstone ileus should be suspected in the elderly with SBO symptoms. Early diagnosis can reduce post-operative complications. Treatment is urgent laparotomy, and surgical treatment must be individualized for each case. The majority of patients in this study were treated with enterolithotomy, with cholecystectomy being performed later in two symptomatic patients.

Treatment of gallstone ileus by single stage surgery of a patient with incidental Meckel diverticulum: A case report

Treatment of gallstone ileus by single stage surgery of a patient with incidental Meckel diverticulum: A case report

Intestinal obstruction caused by gallstone: report of 5 cases and review of the literature

To explore clinical features, diagnostic methods and treatment of gallstone ileus. Clinical data of 5 patients with gallstone ileus were analyzed retrospectively. Pertinent literature from China between 2000 and 2009 were reviewed. The disease onset, clinical manifestations, imaging characteristics, diagnosis and treatment of gallstone ileus were studied. Four out of 5 patients were female aged over 60, of whom 3 had a previous history of cholelithiasis, 2 had a history of cholangiojejunostomy internal drainage procedure. Four patients underwent enterotomy and gallstone extraction combined with hepatobiliary operation, while one underwent enterotomy alone. There was no postoperative recurrence. A review of the literature from China revealed 441 cases with intestinal obstruction caused by gallstone, consisting 1.15% of all the cases with bowel obstruction. 67.12% were female. 73.56% were elderly. 87.92% were from cystoenteral fistula. Site of bowel obstruction in ileum was 64.17% of the cases. 71.89% were misdiagnosed with other types of obstruction. Two hundred twenty-five patients underwent enterotomy and gallstone extraction combined with hepatobiliary operation, which carried a lower rate of postoperative recurrence and malignancy (P<0.05) than enterotomy alone. There were no statistical significant differences in the occurrence of postoperative cystoenteral fistula, wound infection, pulmonary infection, cure rate, and mortality(P>0.05). The incidence of gallstone ileus is low and more common in female elderly. The gallstones often drain through cystoenteral fistula and lodge in the ileum. Enterotomy without hepatobiliary operation is associated with potential risk of recurrence and development of gallbladder malignancy. Combined hepatobiliary operation is recommended in patients without significant comorbidities.

Laparoscopic Management of Multiple Gallstone Ileus

Gallstone ileus is an uncommon cause of small bowel obstruction, occurring when one or more large gallstones erode through the gallbladder and into the intestinal lumen. The presentation is often nonspecific with intermittent symptoms, confounding diagnosis, and delaying treatment. The traditional treatment is through open enterolithotomy. Thus far only 30 of over 400 case reports on MEDLINE describe laparoscopic enterolithotomy. In this article we describe a successful total laparoscopic approach to the treatment of gallstone ileus.

Gallstone ileus: Report of two cases and review of the literature

Gallstone ileus is a rare disease and accounts for 1%-4% of all cases of mechanical intestinal obstruction. It usually occurs in the elderly with a female predominance and may result in a high mortality rate. Its diagnosis is difficult and early diagnosis could reduce the mortality. Surgery remains the mainstay of treatment. We report two cases of gallstone ileus. The first was a 78-year old woman who had a 2-d history of vomiting and epigastralgia. Plain abdominal film suggested small bowel obstruction clinically attributed to adhesions. Later on, gallstone ileus was diagnosed by abdominal computed tomography (CT) based on the presence of pneumobilia, bowel obstruction, and an ectopic stone within the jejunum. She underwent emergent laparotomy with a one-stage procedure of enterolithotomy, cholecystectomy and fistula repair. The second case was a 76-year old man with a 1-wk history of epigastralgia. Plain abdominal film showed two round calcified stones in the right upper quadrant. Fistulography confirmed the presence of a cholecystoduodenal fistula and gallstone ileus was also diagnosed by abdominal CT. We attempted to remove the stones endoscopically, but failed leading to an emergent laparotomy and the same one-stage procedure as for the first case. The postoperative courses of the two cases were uneventful. Inspired by these 2 cases we reviewed the literature on the cause, diagnosis and treatment of gallstone ileus.

A CASE OF GALLSTONE ILEUS CAUSED BY CHOLECYSTOGASTRIC FISTULA

Gallstone ileus is a relatively rare complication of gallstones. It is also rare that cholecystogastric fistula is responsible for this condition. We recently encountered a case of gallstone ileus caused by cholecystogastric fistula. In this case, a radical and one-stage operation on the ileus and the biliary tract was possible under the accurate preoperative diagnosis. A 67-year-old woman was seen at the hospital because of abdominal flatulence and vomiting. When hospitalized, she was in a shock due to ileus. After the improvement of her systemic condition by transfusion therapy and decompression using an ileus tube, a cholecystogastric fistula was detected by endoscopic radiography, and a stone within the intestine, by radiography using an ileus tube. Radical operation was subsequently performed. In the treatment of gallstone ileus, both relief of the ileus and disposal of the internal biliary fistula are required. This condition can be treated radically with one-stage operation after appropriate management and accurate diagnosis.